Urethral diverticula remain problematic from both diagnostic and therapeutic standpoints. Recent developments in pelvic imaging with computed tomography, sensitive ultrasonography, and magnetic resonance imaging have greatly advanced diagnostic acumen and improved the clinician's ability to stage lesions as to location, size, and coexistent pathology. Coupled with improved recognition has come advancements in surgical technique, reflective of improved understanding of urethral anatomy and function. Better use of concomitant procedures, such as pubovaginal sling or soft tissue interposition, has continued a steady trend toward improved surgical outcomes when considering urethral function and urinary continence. This article reviews these mutually complementary trends.